Microdosing

In healthcare B2B sales, the deal is often shaped before ROI is fully debated. It begins when a buyer asks a simpler question: what could go wrong?

Healthcare sales is methodical, slow, and process heavy. Health systems are not optimized for novelty or speed alone. They are optimized to avoid harm while maintaining continuity of care. Safety may not sound exciting, but for anyone selling into a hospital or large health system, it is often where deals gain or lose momentum.

Buyers are not primarily asking how much upside a solution creates. They are asking how much risk it introduces. That does not mean upside is irrelevant. It means upside is filtered through a risk lens.

No one wakes up hoping to use a hospital. Patients do not browse health systems the way they browse airlines, hotels, or retailers. They do not long for novelty, delight, or emotional connection in the usual sense. They arrive when something hurts, when something feels wrong, or when uncertainty becomes too heavy to ignore. In healthcare, usage is driven by need, not desire. 

This distinction changes everything about how a brand is built, perceived, and sustained. It also explains why many branding conversations feel disconnected from patient experience. Consumer research from NRC Health and Press Ganey consistently shows that trust and confidence are the primary drivers of choice and recommendation when stakes are high. Affection or excitement play a minimal role. 

Why platforms, platform-aligned solutions, and upgrade portfolios are replacing standalone products.

Healthcare is entering a phase where the economics of growth have fundamentally changed. The companies scaling fastest are not launching more features, more products, or more narrowly defined point solutions. Instead, they are making a different kind of investment by building platforms designed for reuse. 

Healthcare innovation still loves elegant stories. Unfortunately, elegant stories don’t get funded when budgets are constrained. For years, the industry has relied on value narratives that sound reasonable but collapse under scrutiny. The most common failure is distance in the value chain. They often sound like: “If imaging quality improves, outcomes improve. If outcomes improve, costs go down.” Each step may be directionally true, but between the first link and the last sit dozens of confounding variables, including physician behavior, care pathways, payer policy, patient compliance, downstream utilization, and time. When value depends on all of them lining up, it is not value; it is a wish. 

Healthcare innovation still loves elegant stories. Unfortunately, elegant stories don’t get funded when budgets are constrained. For years, the industry has relied on value narratives that sound reasonable but collapse under scrutiny. The most common failure is distance in the value chain. They often sound like: “If imaging quality improves, outcomes improve. If outcomes improve, costs go down.” Each step may be directionally true, but between the first link and the last sit dozens of confounding variables, including physician behavior, care pathways, payer policy, patient compliance, downstream utilization, andtime. When value depends on all of them lining up, it is not value; it is a wish.

If you’ve attended any healthcare conference, a pattern emerges so consistently that it becomes impossible to ignore: healthcare is not suffering from a lack of innovation. It is suffering from an oversupply of disconnected innovations, where each one is well-intentioned, each one promising value, and each one adding yet another layer to an already unmanageable tech landscape.

The US healthcare system is privatized and built around a capitalist model. Within that framework, one flaw stands out: unlike nearly every other high-performing health system in the world, the United States lacks a true backbone. There is no layer that reliably guides people, connects decisions over time, or helps them confidently take the next step. The solution is the backbone it never built, and that backbone is primary care.

Healthcare does not lack workers; it lacks a work model capable of supporting them. Modern care assumed infinite elasticity from clinicians, but that model has reached its limit. What comes next is not incremental change; it is reconfiguration: team-based, patient-centered, digitally enabled, and economically aligned with value. When the work is redesigned, the workforce stabilizes. This necessary reconfiguration is not a trend; it is an inescapable reality.

The complexity of the U.S. healthcare system is magnified by inconsistent, fragmented naming of care locations. Terms such as hospital, medical center, and institute may appear interchangeable, but in practice they introduce confusion, increase the risk of surprise billing, and fuel costly administrative errors. 

Every healthcare organization operates within a web ofoverlapping experience maps, including clinical, administrative, payer, patient, and policy maps. These maps shape every decision, workflow, and outcome. In healthcare, a customer experience (CX) map traces the steps, systems, and emotions that patients, clinicians, and staff move through as care is delivered and supported. Each map makes sense on its own, but the real complexity begins where they overlap. Most improvement efforts focus on a single map, yet few consider how these maps interact or depend on one another.

Every industry has a process that looks small on paper butshapes everything around it. In healthcare, that process is priorauthorization. It is the quiet monster that hides between doctors, payers, and patients, invisible to most until it strikes. When it does, it does not just delay care; it unravels trust, burns out staff, and corrodes the very idea of a coordinated patient journey.

Hospitals were once the epicenter of healthcare food service. One kitchen fed thousands, one cafeteria served everyone from physicians to visitors, and one model defined the experience. That era is ending.

As care moves beyond the hospital walls into outpatient clinics, ambulatory centers, imaging hubs, and patients’ homes, food service needs to move with it. What once was a static operation is becoming a dynamic, distributed network designed to keep up with an always-on health system.

For years, the story of American healthcare has read like an obituary for small, independent medical practices. Faced with shrinking reimbursements, staffing shortages, and rising administrative burden, many physicians traded autonomy for stability, selling to health systems or private equity. Yet beneath the consolidation headlines, a quiet rebellion is taking shape. Across the country, small specialty and multi-site practices are not only surviving but posting strong margins. They’re lean, tech-forward, and operationally disciplined, proving that small can be powerful when run like a high-performing business.

All around you, Healthcare leadership continues to lean on familiar solutions: more education, more empowerment, more reminders to improve adherence. It sounds polite,nonthreatening, and promising. But it’s also a comfortable excuse that obscures a deeper, systemic failure. Because the truth is: medication adherence—our most basic measure of patient engagement—remains stubbornly low. Despite decades of well-meaning interventions, the problem persists. This isn’t a patient failure. It’s a system failure.

Modern Primary Care Diagnostic Sequences; Why the Future of Care Hinges on Faster, Smarter Diagnostics. Traditionally, and still in many practices today, some of the most important parts of a primary care visit happen after the patient leaves the exam room. Diagnosis is often delayed, follow-up decisions are disconnected from the visit itself, and early opportunities for intervention can be missed. The diagnostic sequence may be the least celebrated yet the most essential part of a primary care visit. Whether it’s a healthy 25 year old seeking reassurance or a 45 year old at risk for diabetes, the pattern is the same: see the doctor, get the labs, wait for results, then discuss what it all means. This four step routine isn’t just tradition, it’s the structure payers recognize, the basis on which health system workflows are built, and the process clinicians rely on to deliver care.

As demand for GLP-1 drugs like Ozempic and Wegovy soars, a parallel market for compounded versions has emerged — one that’s largely unregulated and increasingly risky. This episode examines how gaps in oversight, aggressive marketing, and blurred lines between compounding and manufacturing expose patients to safety concerns and strain the health system. We explore why compounded GLP-1s are more than a niche issue, highlighting how they fit a recurring pattern where regulation lags behind fast-moving markets.

Medicaid and Medicare Advantage may seem like programs for specific groups, but the choices made in these public plans ripple across the entire insurance system. This episode explores how coverage churn, capped benefits, and financing reforms in public programs ultimately shape commercial premiums, provider networks, and patient access for everyone. We unpack why what starts in Medicaid and Medicare Advantage rarely stays there, and how those shifts end up reshaping all of our coverage.

Primary care consolidation is changing how patients experience — and pay for — everyday healthcare. This episode examines how ownership, pricing, and place intersect to drive up costs, with research from The Journal of the American Medical Association showing that hospital and private equity–affiliated practices charge more without delivering clear quality gains. We unpack what this hidden shift means for patients, insurers, and the future of affordable primary care.

Firearms have become the leading cause of death among U.S. children and teens, yet unlike cars, toys, or even e-cigarettes, they remain exempt from basic consumer safety regulation. This episode explores the public health and economic costs of treating guns as constitutionally protected products rather than consumer goods, drawing on recent research and commentaries from The Journal of the American Medical Association (JAMA) and JAMA Health Forum. We highlight what a true public health approach could look like (from child locks to smart-gun technology) and why closing this regulatory gap could save lives and reduce systemwide costs.

Patients are no longer entering care through the doors traditional health systems control. This episode explores how retail brands, pharma platforms, and digital experiences are becoming the new “front doors,” transferring trust and reshaping where care journeys begin. We look at what this shift means for partnerships, brand equity, and how healthcare organizations must adapt to stay relevant at the first point of engagement.

Rising clashes between hospitals and insurers are exposing outdated fee-for-service infrastructure. As payer–provider clashes surge, healthcare infrastructure is under pressure. We unpack what’s fueling these disputes, how they impact patients, and why flexible platforms may be the key to moving forward.

From weight loss buzz to healthcare infrastructure, GLP-1 drugs started as diabetes treatments but are now reshaping weight loss, care delivery, and consumer markets. In this episode, we explore how they have become more than medicine, driving new business models, digital access points, and patient expectations, featuring insights from leaders across health plans, startups, and strategy firms.

Microdosing is adjusting its format. This episode gives listeners a sneak peek at how Microdosing will be adopting a report-based, written-format-first approach to content. And be moving deeper into the 21st century by having those reports converted to audio podcasts using our new AI-based narrator, Mavis.

For years, the story of American healthcare has read like an obituary for small, independent medical practices. Faced with shrinking reimbursements, staffing shortages, and rising administrative burden, many physicians traded autonomy for stability, selling to health systems or private equity. Yet beneath the consolidation headlines, a quiet rebellion is taking shape. Across the country, small specialty and multi-site practices are not only surviving but posting strong margins. They’re lean, tech-forward, and operationally disciplined, proving that small can be powerful when run like a high-performing business.

We interviewed a group of terrific product leaders during this time. Looking back, here are a few of our observations.

Product Management guru and wannabe Premier League goalie, Alex Moseman, joins us for this episode. He talks about his experience leading product efforts in medical devices, healthcare services, and various other industries.

From Apple, to designing the patient experience in medsurge wings, to now leading Business Design efforts at Prophet, Jo brings an incredibly robust view to product management and value creation for both the customer/user and the business.

Jitin Asnaani, Chief Product Officer of Rhapsody, joins us in this episode where we talk about the different ways to talk about the productization of data, interpretability, and [fill in the blank] as a service.

Stephanie Rock of Intus Care joins us in this episode, and talks about how value based care needs to be managed in its totality. It's not just plan design. It's not just a care delivery model. Everything needs to be factored into it, as all of it affects outcomes.

Robert Laumeyer of Availity joins us in this episode, bringing his experience in tech, his patterns that have contributed to product experiences at Google, Microsoft, and HP. We talk about the importance of communication in product management and the great work he's doing at Availity to address problems with pre-authorization.

Sarah Reilly of Lucet talks about the importance of bringing a blended product management approach to both tech and service elements of an experience. Arguing to include the environment in which your product is deployed should be factored into your overall product design and management approach.

In this episode, Marina Simonian of Uptiv Health talks about how she brings her background in psychology -and finding ways to make things happen with whatever you have on hand- to her role as Product Lead and Founder at Uptiv Health.

Med student -turned- consultant -turned- strategist -turned- product executive, Megha Kadiyala joins us on this episode to share her perspectives on Product Management and user flows in today's pharmacy space.

Self-proclaimed misfit clinician, Alex Hoopes, joins us in this episode to discuss his vides and philosophies on product development, and the latest reconning for greater pragmatism, and not just asking product leaders to own innovation, but be accountable for driving value.

From some of the smallest, fastest-growing healthcare companies to literally the biggest of the bigs, Alice McNeil's career has spanned nearly every function of the organization, and she brings a very unique and powerful perspective to the world of Products.

Kord Brasher sits down in this episodes and shares his experience working at places such as UnitedHealth Group, EPAM Continuum, Catapult Thinking, and now Compeer Financial.

Brandon Fiegoli of Farbric joins us for this episode and shares his philosophies and best practices that he’s picked up throughout his career which includes IBM and Butterfly Network.  He also talks about why it’s important to always as ASK MORE QUESTIONS!

Product Management (and the variety of overlapping functions of R&D, Innovation, and Product Development) is a fast-growing sector, yet many Healthcare companies appear to be deficient in its basic core tenets. In this series, we do a deep dive into all things product, and Paul shares his perspective in this opening episode.

The series wouldn't be complete without a conversation with my good friend Jeff Gourdji. He sits down to talk about healthcare policy, midwest healthcare innovation, and the University of Michigan Wolverines.

Adrienne Albright sits down and discusses bloodletting and other things related to medieval science on this episode of Microdosiong.

On this episode, Nicole Diamant not only shares great perspectives into the work at Prophet, but she also provides some great career advice overall.

Tanisha Shah joins us in this episode.  With a background in digital commerce, business analytics, and studying abroad, she brings a very unique set of perspectives and skills focused on the importance of putting consumers at the center of healthcare.   

Meet another fantastic member of Prophet's healthcare team: Ellie Winslow. A lot of people say they are fast learners, but Ellie takes it to another level. The speed in which she gets up to speed on almost anything (oftentimes on her own for better or worse) is mind-boggling.

We all wear many hats at Prophet, and Alisha Shah wears several.  She kicks off our series, centered around Paul’s coworkers at Prophet and the work they do.  Alisha shares her perspectives on always bringing a perspective and balancing strategy, rigor, and creativity. 

There were so many terrific conversations with Paul and Geoffrey throughout the Labor Crisis Series. It was impossible to know where to begin or end. That said, here are their highlights and take aways.

Danielle McCamey, DNP, ACNP-BC, FCCP, CEO of DNPs of Color, and Assistant Dean at Johns Hopkins School of Nursing, talks about creating inclusive spaces for today's modern healthcare workforce, and the importance of pulling more nurses up into overall leadership roles of healthcare organizations.

Dr. Dan Weberg, PhD, MHI, RN, FAAN talks about the gap in healthcare innovation between technology designed for nurses that lacks nurse input, as well as scaling challenges around service-line-based business models.

Whitney Staub-Juergens DNP-HSL, MSN, RN, CCRN-K, NE-BC is the Vice President of Clinical Transformation and Innovation at HCA Healthcare. She talks about how today's hospitals have technical infrastructures that are struggling to keep up with today's care needs.  And that some of these tech and digital gaps have created extra work via "human patches".  She also showcases HCA Healthcare's Clinical Transformation and Innovation efforts, particularly as relates to how they are redefining the nurse scheduling experience. 

Dr. Heidi Chumley, Dean of Ross University School of Medicine talks about "social determinants of learning" as it relates to clinical education, and how we need to rethink the pipeline of the next-generation doctors and nurses; where we are sourcing students and educating a more diverse clinical workforce of the future. 

Jeff Terry, CEO of GE Healthcare Command Centers, talks about how their technology -and others like it- is dramatically reducing the amount of time care teams need to identify, understand, and act on a variety of care delivery needs.